Poverty leads to health problems for rural kids

Children in Ohio's rural counties face health problems their city peers don't, and the gap is getting worse in some areas, according to a Children's Defense Fund report released Thursday.

More than 28 percent of children in Ohio's Appalachian counties, including Coshocton County, lived in poverty compared with the state average of 23 percent, according to the report.

While the poverty rate for Ohio's children grew statewide by 75 percent between 2002 and 2012, the rate for children in rural, non-Appalachian counties grew 92 percent; the rate for children in Appalachian counties grew 70 percent, according to the report.

In Coshocton County, the childhood poverty rate was 29 percent, according to the Ohio Department of Job and Family Services' 2013 county profile.

Children in rural areas are more likely to face food insecurity and obesity than their urban peers.

"It seems counterintuitive. In an area with rich farmland, we're talking about families who live many miles from grocery stores or supermarkets," said Sarah Biehl, policy director for the Children's Defense Fund-Ohio.

About 24 percent of people in rural households must drive more than 10 minutes to reach a retail food store, which might not stock fresh fruits and vegetables, according to research from Ohio State University's Center for Farmland Policy Innovation. Even if people are within driving distance of a store, about 5 percent of rural homes don't own a vehicle.

Lack of access to nutritious foods can lead to obesity, which occurs disproportionally in rural Ohio, said Sherri Oliver, executive director of Live Healthy Appalachia.

"A lot of what we see as an organization when we're working with children is an epidemic of childhood obesity," Oliver said.

Access to pediatric care also is a challenge in rural counties, said Melissa Wervey Arnold, executive director of the Ohio chapter of the American Academy of Pediatrics. There are federal incentives, such as school loan repayment, available for physicians who live in rural or undeserved areas, but finding people for the jobs can be difficult.

"They do it because they just love working with patients, but obviously some specialties pay more," she said.

Pediatricians in rural Ohio also receive less assistance from colleagues, who might not work in the same city, Wervey Arnold said.

Children's Defense Fund-Ohio made several suggestions to stem the problem: teach families how to grow nutritious food, promote exercise, create tax incentives for businesses to stock fruits and vegetables, and allow nurses and dental hygienists to perform basic procedures without oversight, Biehl said.

Some people are concerned allowing nurses and dental hygienists greater autonomy would lower the quality of care, but it's an option worth discussing when some counties have few dentists that accept Medicaid, Biehl said.

"All options should be on the table when we're thinking creatively," she said.